Continuing Care Provider definition

Continuing Care Provider. A provider who has an agreement with the BadgerCare Plus and/or Medicaid SSI program to provide:
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Continuing Care Provider. A provider who has an agreement with the BadgerCare Plus and/or Medicaid SSI program to provide: • Any reports that the Department may reasonably require, and • At least the following services to eligible HealthCheck members formally enrolled with the provider as enumerated in 42 CFR §441.60(a)(1)-(5): o Screening, diagnosis, treatment and referrals for follow-up services; o Maintenance of the members consolidated health history, including information received from other providers; o Physician’s services as needed by the member for acute, episodic or chronic illness or conditions; o Provision or referral for dental services; and o Transportation and scheduling assistance.
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Continuing Care Provider means (as stated in 42 CFR 441.60(a)) a provider who has an agreement with the Medicaid agency to provide:
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Examples of Continuing Care Provider in a sentence

  • Formally Enrolled with a Continuing Care Provider (as cited in 42 CFR 441.60(d)): A member, member’s guardian, or authorized representative agrees to use one continuing care provider as the regular source of a described set of services for a stated period of time.


More Definitions of Continuing Care Provider

Continuing Care Provider. A provider who has an agreement with the Department to provide: • Any reports that the Department may reasonably require, and • At least the following services to eligible HealthCheck members formally enrolled with the provider as enumerated in 42 CFR 441.60(a)(1)-(5): o Screening, diagnosis, treatment and referrals for follow-up services; o Maintenance of the members consolidated health history, including information received from other providers; o Physician’s services as needed by the member for acute, episodic or chronic illness or conditions; o Provision or referral for dental services; and o Transportation and scheduling assistance. Contract Services: Services that the PIHP is required to provide under this Contract. Contractor: An entity to which the PIHP awarded a contract resulting from the Xxxxxx Care Medical Home (FCMH) certification process to provide managed care in accordance with this Contract. Coordination of Benefits (COB): Industry term applied to agreements among payers to assign liability and to perform the end-to-end payment reconciliation process. This term applies mostly to the electronic data interchanges associated with Health Insurance Portability and Accountability Act (HIPAA) transactions.
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Continuing Care Provider. A provider who has an agreement with the Department to provide:  Any reports that the Department may reasonably require, and  At least the following services to eligible HealthCheck members formally enrolled with the provider as enumerated in 42 CFR 441.60(a)(1)-(5): o Screening, diagnosis, treatment and referrals for follow-up services; o Maintenance of the members consolidated health history, including information received from other providers; o Physician’s services as needed by the member for acute, episodic or chronic illness or conditions; o Provision or referral for dental services; and o Transportation and scheduling assistance. Contract: The agreement executed between the PIHP and the Department to accomplish the duties and functions, in accordance with the rules and arrangements specified in this document. Contract Services: Services that the PIHP is required to provide under this Contract. Contractor: A PIHP awarded a contract resulting from the Xxxxxx Care Medical Home (FCMH) certification process to provide managed care in accordance with this Contract. Coordination of Benefits (COB): Industry term applied to agreements among payers to assign liability and to perform the end-to-end payment reconciliation process. This term applies mostly to the electronic data interchanges associated with Health Insurance Portability and Accountability Act (HIPAA) transactions. Corrective Action Plan: Plan communicated by the State to the PIHP for the PIHP to follow in the event of any threatened or actual use or disclosure of any Confidential Information that is not specifically authorized by this Agreement, or in the event that any Confidential Information is lost or cannot be accounted for by the PIHP. This also refers to the plan communicated to the State by the PIHP to address a deficiency in contractual performance. Covered Entity: A health plan (such as an PIHP), a health care clearinghouse, or a health care provider that transmits any health information in electronic form in connection with a transaction covered by 45 CFR Parts 160 and 162. Culturally Competent: A set of congruent behaviors, attitudes, practices and policies that are formed within an agency, and among professionals that enable the system, agency, and professionals to work respectfully, effectively and responsibly in diverse situations. Essential elements of cultural competence include understanding diversity issues at work, understanding the dynamic of difference, institutionalizing ...
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Continuing Care Provider. A provider who has an agreement with the Department to provide:
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Continuing Care Provider. A Provider who formally agrees: to provide to enrolled individuals in Medicaid, screening, diagnosis, and treatment for conditions identified during EPSDT screening visits (within the Provider’s capacity) or referral to a Provider capable of providing the appropriate services; maintains a complete health history, including information received from other Providers; is responsible for providing needed physician services for acute, episodic and/or chronic illnesses and conditions; and ensures accountability by submitting reports reasonably required by the Contractor and/or DCH. Contract: The written agreement between the State and the Contractor; comprised of the Contract, any addenda, appendices, attachments, or amendments thereto. Contract Award: The date upon which the Apparent Successful Vendor Letter(s) is issued by the Department of Administrative Services. Contract Effective Date: The date when the rights and obligations under the Contract become operational. For purposes of this Contract, the Effective Date is the date upon which the Centers for Medicare and Medicaid Services of the United States Department of Health and Human Services (CMS) approves the Terms and Conditions of the Contract. Contract Execution Date: The date upon which all Parties have signed the Contract.
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Related to Continuing Care Provider

  • Continuing care contract means, as stated in RCW 70.38.025, a contract providing a person, for the duration of that person's life or for a term in excess of one year, shelter along with nursing, medical, health-related, or personal care services, which is conditioned upon the transfer of property, the payment of an entrance fee to the provider of such ser- vices, or the payment of periodic charges for the care and ser- vices involved. A continuing care contract is not excluded from this definition because the contract is mutually termina- ble or because shelter and services are not provided at the same location.

  • Primary Care Provider (PCP) means a health care professional who is contracted with BCBSAZ as a PCP and generally specializes in or focuses on the following practice areas: internal medicine, family practice, general practice, pediatrics or any other classification of provider approved as a PCP by BCBSAZ. Your benefit plan does not require you to have a PCP or to have a PCP authorize specialist referrals.

  • Primary care provider (PCP) means, for the purpose of this plan, professional providers that are family practitioners, internists, and pediatricians. For the purpose of this plan, gynecologists, obstetricians, nurse practitioners, and physician assistants may be credentialed as PCPs. To find a PCP or check that your provider is a PCP, please use the “Find a Doctor” tool on our website or call Customer Service.

  • Care provider means a duly qualified or licensed home health aide or homemaker, personal care aide or nurse provided through a licensed home health care agency or referred by a licensed referral agency or licensed nurses registry.

  • Health care provider or "provider" means:

  • Continuing care retirement community means a residential

  • Licensed health care provider means a physician, physician assistant, chiropractor, advanced registered nurse practitioner, nurse, physical therapist, or athletic trainer licensed by a board.

  • Qualified long-term care services means services that meet the requirements of Section 7702(c)(1) of the Internal Revenue Code of 1986, as amended, as follows: necessary diagnostic, preventive, therapeutic, curative, treatment, mitigation and rehabilitative services, and maintenance or personal care services which are required by a chronically ill individual, and are provided pursuant to a plan of care prescribed by a licensed health care practitioner.

  • Primary care-giver means a person who assumes the principal role of providing care and attention to a child.

  • Continuing education provider or “CE provider” means an individual or entity that is approved to offer continuing education courses pursuant to [insert reference in State law or regulations governing producer continuing education course approval].

  • Emergency medical care provider means an individual who has been trained to provide emergency and nonemergency medical care at the first responder, EMT-basic, EMT-intermediate, EMT-paramedic, paramedic specialist or other certification levels recognized by the department before 1984 and who has been issued a certificate by the department.

  • Indian Health Care Provider means a health care program operated by the Indian Health Service (IHS) or by an Indian Tribe, Tribal Organization, or Urban Indian Organization (otherwise known as an I/T/U) as those terms are defined in § 4 of the Indian Health Care Improvement Act (25 USC § 1603). Indian Health Care Provider includes a 638 Facility and provision of Indian Health Service Contract Health Services (IHS CHS).

  • Non-Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) does not have a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has not been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.

  • Participating Hospice Care Program Provider means a Hospice Care Program Provider that either: (i) has a written agreement with the Claim Administrator or another Blue Cross and/or Blue Shield to provide services to participants in this benefits program, or; (ii) a Hospice Care Program Provider which has been designated by a Blue Cross and/or Blue Shield Plan as a Participating Provider Option program.

  • Primary care physician means a physician qualified to be an attending physician according to ORS 656.005(12)(b)(A) and who is a general practitioner, family practitioner, or internal medicine practitioner.

  • Non-Participating Certified Nurse-Midwife means a Certified Nurse-Midwife who does not have a written agreement with Blue Cross and Blue Shield of Illinois or another Blue Cross and/or Blue Shield Plan to provide services to you at the time services are rendered.

  • Deep poverty pocket means a population census tract having a

  • Financial Services Provider means any Lender and any other provider of financial services or products;